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One-Third of Patients on Anticoagulants at Risk of Serious Interactions Due to OTC Meds

Most patients don’t know much about drug interactions, but that doesn’t stop them from deciding to take an over-the-counter medication without consulting a health professional.

That’s the major conclusion of a recent, disturbing research published in the Journal of the American Geriatrics Society. It found 98 percent of people prescribed direct-acting oral anticoagulants, a class of newly available blood thinners, also use OTC products. Of those, 33 percent took at least one OTC item daily that could interact with the anticoagulants and potentially cause internal bleeding. Almost 7 percent took two or more.

The most common of these prescriptions is apixaban. Other common options include dabigatran, rivaroxaban and edoxaban. These drugs prevent stroke in atrial fibrillation patients.

What Did the Study Look at?

For the study, researchers surveyed 791 English- and Spanish-speaking apixaban patients about their knowledge of potential interactions between the drug and OTC supplements. The questions focused on how often participants took: aspirin, ibuprofen/naproxen, acetaminophen, and 13 common dietary supplements, such as Chinese herbs, various fish oils, ginger and herbal teas.

The survey revealed aspirin was the most commonly used OTC medication. Of those using aspirin, almost two-thirds took at least one other nonprescription product that could increase the risk of internal bleeding.

What Does the Study Mean for Health Professionals?

The study authors deduced that most patients taking direct-acting anticoagulants lacked knowledge of potentially serious drug interactions. What’s more, most of these individuals are not followed in specialized anticoagulation clinics or seen monthly by health care professionals. Patients taking previously popular blood thinners, such as warfarin need regular blood tests to monitor side effects, but that’s not the case with individuals on the newer drugs.

“Because such a large number of people lack knowledge of these interactions, there is a need to educate patients and healthcare providers about the dangers that these combinations may pose,” the researchers note. “In addition, data are needed on outcomes in people combining apixaban and over-the-counter products.”


Prevalence and Knowledge of Potential Interactions Between Over‐the‐Counter Products and Apixaban, Journal of the American Geriatrics Society.

33% of people on anticoagulants take OTC supplements with potentially serious interactions, EurekAlert.

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